Having more brothers and sisters may make it easier to cope with the death of a parent, in midlife, particularly when it’s the mother who dies, suggests research published online in the Journal of Epidemiology & Community Health .
Fewer mental health drugs are bought by those with more siblings, especially women, in the aftermath of a parental death, the findings show.
The death of a parent is traumatic for young children and teens, but there’s little evidence on the emotional impact of parental death on adults, even though middle or older age is often when people have to face this, explain the researchers.
While various factors may influence the grieving process and its effect on mental health, not much is known about the potential impact of facing parental death with brothers and sisters, they add.
To shed more light on this, the researchers looked at the purchasing patterns of psychotropic medicines (antidepressants, anti-anxiety drugs, sedatives, and sleeping pills) 3 years before and 3 years after the death of a parent in 35 to 55 year old Finnish residents between 2006 and 2016, drawing on national registry data.
The final analysis included 1,368,619 people with 0-3 siblings, 12.5% of whom had experienced the death of their mother, and 1,041,981 people, 23% of whom had experienced the death of their father.
Having fewer siblings was generally associated with a higher probability of mental health medication purchases, and among those experiencing a parental death, these purchases rose in the year before the death and peaked the following year.
The annual prevalence of mental health drug purchases ranged from 12% to 21%, increasing over time in all groups. But the sharpest increases were among those whose mother had died and those with fewer siblings.
The fewer siblings a person had, the greater the probability of mental health drug purchases, especially in the year after their mother’s death.
The probability of medication purchases was 5.1 percentage points higher among only children than it was among only children who hadn’t lost their mother the same year.
This compares with a percentage point difference of 4.3 for those with one sibling, 3.5 for those with two siblings, and 2.6 for those with three siblings.
The differences by sibship size were already apparent in the year leading up to the mother’s death: 2.8 percentage points higher for only children; 2.2 for those with one sibling; 2 for those with two siblings; and 1 for those with three siblings.
The medication prevalence was highest for women after a mother’s death, and being the only child was associated with a 6.8 percentage point difference between those who had experienced this and those who hadn’t.
Similarly, the percentage point difference was 6.1 among those women with one sibling, 4.7 among those with two, and 3.9 among those with three siblings, although these differences by sibship size mostly weakened more than a year after a mother’s death.
Purchasing patterns were different for a father’s death, however, the probability of medication purchases only increased in the year afterwards. And the increase was generally smaller than that observed for a mother’s death and was similar regardless of sibship size.
Mental health drug purchases also varied by cause of death: parental deaths due to dementia were associated with higher numbers of purchases throughout the study period, regardless of sibship size.
But the most notable differences by sibship size were observed for maternal deaths due to cancer, where mental health medication purchases strongly increased in the year beforehand, particularly among those with fewer siblings.
This is an observational study, and as such, no firm conclusions can be drawn about cause and effect. And the researchers emphasise that they couldn’t account for the potential influence of social networks, loved ones, friends, or half-siblings.
They also caution that the stronger associations found for women might be explained by the fact that men tend not to seek help for mental health issues as much as women do. And medication purchase doesn’t necessarily reflect medication use either.
However, the researchers suggest that there are plausible explanations for their findings, including the emotional and practical support and shared care-taking that siblings can provide before and after a parental death, which might mitigate the emotional repercussions.
Similarly, parental attachment might be stronger in smaller families, which might prompt a stronger emotional response when a parent dies.
“Considering the shrinking kinship networks in many ageing societies, children may face increasing strain as their parents near the end of their lives,” they conclude.
Journal of Epidemiology and Community Health
Observational study
People
Number of siblings and psychotropic medication purchases surrounding parental death in adulthood: a population-wide cohort study in Finland
31-Mar-2026